ST DOMINIC-JACKSON MEMORIAL HOSPITAL
NPI 1306876065
General Acute Care Hospital in Jackson, MS

Q: What is St Dominic-Jackson Memorial Hospital's NPI number?

The NPI number for St Dominic-Jackson Memorial Hospital is 1306876065. It was assigned to this organization in the NPPES registry on July 5, 2006.

Q: What is St Dominic-Jackson Memorial Hospital's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

Active since July 05, 2006

969 LAKELAND DR, JACKSON, MS 39216(601) 200-2000(601) 200-0924 Get Directions Write a Review

NPPES record last updated: September 18, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 18, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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About St Dominic-jackson Memorial Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST DOMINIC-JACKSON MEMORIAL HOSPITAL (NPI 1306876065) is a healthcare organization registered as a general acute care hospital in Jackson, Mississippi and active in the NPI registry since July 2006. The organization lists Samuel Thaddeus Scott, Cfo, as its authorized official.

NPPES Registry Identity

NPI1306876065

Entity TypeOrganization

Primary Taxonomy282N00000X

Legal Business NameST DOMINIC-JACKSON MEMORIAL HOSPITAL

Location Address969 LAKELAND DRJackson, MS 39216-4606

Mailing Address969 Lakeland DrJackson, MS 39216-4606 · (601) 200-2000 · Fax (601) 200-0924

Phone(601) 200-2000

Fax(601) 200-0924

Organization SubpartNo

Authorized OfficialSamuel Thaddeus ScottCfo · (601) 200-6570

Enumeration DateJuly 5, 2006

Last NPPES UpdateSeptember 18, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 18, 2025

✔ NPI 1306876065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care HospitalHospitals

Taxonomy Code282N00000X

License✔ Licensed in MS · 14-031

Definition

An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

969 LAKELAND DR, Jackson, MS 39216

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Other Identifiers 2

Other000020034MS · Mississippi Blue Cross

Medicaid00020034MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St Dominic-jackson Memorial Hospital is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to St Dominic-Jackson Memorial Hospital, which bills Medicare for the services this clinician delivers.

Clinician (1)

Richard Guynes, MD

Interventional Cardiology

NPI 1770526568

970 LAKELAND DR SUITE 61
Jackson, MS 39216

(601) 982-7850

✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Dominic-Jackson Memorial Hospital's NPI number?

The NPI number for St Dominic-Jackson Memorial Hospital is 1306876065. It was assigned to this organization in the NPPES registry on July 5, 2006.

Where is St Dominic-Jackson Memorial Hospital located?

St Dominic-Jackson Memorial Hospital is located at 969 Lakeland Dr, Jackson, MS 39216. The listed phone number is (601) 200-2000.

What is St Dominic-Jackson Memorial Hospital's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

Is St Dominic-Jackson Memorial Hospital enrolled in Medicare?

Yes. St Dominic-Jackson Memorial Hospital is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through St Dominic-Jackson Memorial Hospital?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Interventional Cardiology) reassigns their Medicare billing to St Dominic-Jackson Memorial Hospital. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does St Dominic-Jackson Memorial Hospital accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee list St Dominic-Jackson Memorial Hospital as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St Dominic-Jackson Memorial Hospital was last updated on September 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.